TREASURER

Year

Club Name

Treasurer

Treasurer’s Address

Phone ILLINO IS 4 – H CLUBS

ILLINOIS 4 – H CLUBS RECORD BOOK

Illinois 4-H Club Annual Financial Statement

Itemization of Miscellaneous

expenses (Required):

In order to re-enroll, a completed financial statement and fiscal review

must be submitted to the county Extension Office and approved by the County Extension Director.

**PLEASE COMPLETE ALL SECTIONS**

This financial statement is for the period September 1, ____ _ through August 31,______4-H Club Name _______________________________________________________________________________

County _______________________________ Employer Identification Number (EIN) ______________________

Checking account balance at _____________________________________________________________________ (Name of Financial Institution)

Checking account number _______________________________________________________________________

1. Beginning Account Balance as of September 1, ____ $__________________

Income:

$____________

$____________

$____________

2. Income Source:

A. Donations

B. Fundraisers

C. Other / miscellaneous - itemize*

D. Total Income (add line A + B + C) $_____________

3. Beginning Account Balance plus Total Income (add line 1 + 2D) $__________________

Expenses:

$____________

$____________

$____________

$____________

$____________

$____________

$____________

$____________

$____________

4. Expense Categories:

A. Meeting expenses / speaker fees

B. Food / refreshments

C. Project manuals / workshops

D. 4-H Program fees

E. Trips

F. Awards / scholarships

G. Community service activities

H. Rental fees**

I. Other / miscellaneous*

J. Total Expenses (add lines A-I) $____________

5. Balance as of August 31, _____ (subtract Total Expenses line 4(J) from line 3) $__________________

6. Outstanding deposits

(Subtract total of deposit amounts that have not appeared on bank statements) $__________________

7. Outstanding checks

(Add total of check amounts that have not appeared on bank statements) $__________________

8. Adjusted Balance (should agree with end of year bank statement) $__________________

**If a contract or agreement is required, the Extension Business Office will obtain the signature for the document on behalf of the 4-H club.

*Itemization of Miscellaneous Income

Required if Income listed in Other

Illinois 4-H Club Annual Financial StatementIn order to re-enroll, a completed financial statement and fiscal review

must be submitted to the county Extension Office and approved by the County Extension Director.

Savings account balance at _____________________________________________________________________ (Name of Financial Institution)

Savings account number _______________________________________________________________________

1. Beginning Account Balance as of September 1_____ $__________________

Income:

$___________

$___________

$___________

$___________

2. Income Source:

A. Donations

B. Fundraisers

C. Other / miscellaneous - itemize*

D. Total Income (add line A+ B + C)

3. Beginning Account Balance plus Total Income (add line 1 + 2D) $__________________

4. Expense Categories:

A. Transfer to checking account

B. Other: _________________

C. Other: _________________

D. Other: _________________

Expenses:

$___________

$___________

E. Total Expenses (add lines A - D)

$___________

$___________

$___________

5. Balance as of August 31, _____ (subtract Total Expenses line 4E from line 3) $__________________

This certifies the above information is a correct statement of financial activity for this 4-H Club.

____________________________________________________________________________________________

(4-H Club Treasurer’s signature) (Date)

____________________________________________________________________________________________

(4-H Club Leader’s signature) (Date)

Fiscal Review: ( REQUIRED: Fiscal Review Committee should include a combination of youth and adults without signatory rights on

the account.)

We have examined the financial records including bank statements, checks written, copies of bills paid, itemized

deposit slips, and receipts of this 4-H Club and find them in good order.

____________________________________________________________________________________________

(Fiscal Review Committee signature) (Date)

____________________________________________________________________________________________

(Fiscal Review Committee signature) (Date)

____________________________________________________________________________________________

(Fiscal Review Committee signature) (Date)

COLLEGE OF AGRICULTURAL, CONSUMER & ENVIRONMENTAL SCIENCESUniversity of Illinois | U.S. Department of Agriculture | Local Extension Councils Cooperating

University of Illinois Extension provides equal opportunities in programs and employment. 2020

Record of Club Finances Record all charges or credits that affect your account

Check Number

Date Description of Transaction Payment/Debit

(-) √ Deposit/Credit

(+)

Balance

*Include name of person receiving check and the reason for the payment OR for deposits, list the source of thedeposits (person and reason)

Record of Club Finances Record all charges or credits that affect your account

Check Number

Date Description of Transaction Payment/Debit

(-) √ Deposit/Credit

(+)

Balance

*Include name of person receiving check and the reason for the payment OR for deposits, list the source of thedeposits (person and reason)

Record of Club Finances Record all charges or credits that affect your account

Check Number

Date Description of Transaction Payment/Debit

(-) √ Deposit/Credit

(+)

Balance

*Include name of person receiving check and the reason for the payment OR for deposits, list the source of thedeposits (person and reason)

Illinois 4-H Club Inventory List all items that belong to the 4-H club, whether purchased with club money or received as gifts. Place an asterisk (*) by items that were purchased or received as gifts this year. Include the name of the person or

business that provided the gift. All club donations should be acknowledged in writing to the donor. A copy of the acknowledgement should be kept in the treasurer’s records.

Quantity Item

1 Gavel, donated by Mary Jones Family

4-H PLEDGEI pledge my HEAD to clearer thinking;

my HEART to greater loyalty;

my HANDS to larger service;

and my HEALTH to better living

for my club, my community, my country, and my world.

4-H MOTTOTo Make The Best Better

Urbana-Champaign, Illinois Revised 2020

COLLEGE OF AGRICULTURAL, CONSUMER & ENVIRONMENTAL SCIENCESUniversity of Illinois | U.S. Department of Agriculture | Local Extension Councils Cooperating

University of Illinois Extension provides equal opportunities in programs and employment.